Abstract Domestic abuse is a persistent public health, safeguarding and human rights challenge. In England and Wales, the Crime Survey for England and Wales estimated that approximately 3.8 million people aged 16 years and over experienced domestic abuse in the year ending March 2025. Dentistry has an important role because interpersonal violence frequently affects the face, mouth and teeth, and a dental appointment may provide an opportunity to access healthcare. However, general dental practitioners may be uncertain how to progress from recognising possible abuse to an appropriate safeguarding response, particularly when disclosure is hesitant or incomplete. Smartphone applications can provide information, safety planning, incident recording and routes to specialist support, but their evidence base and safety implications vary. The strongest peer-reviewed evidence among the resources considered relates to myPlan and related safety decision aids, with benefits for selected outcomes that vary by intervention and population. Digital tools should therefore support, rather than replace, professional judgement. This narrative review critically appraises selected digital resources and sets out a conceptual dental safeguarding pathway centred on privacy, sensitive enquiry, objective documentation, risk assessment and proportionate referral or escalation.
To evaluate the effect of different chemical pretreatments of sound dentin on the microtensile bond strength (µTBS) of resin composite to dentin. A comprehensive online search was performed across four electronic databases: PubMed (Medline), Web of Science, Scopus, and the Cochrane libraries to identify relevant studies, followed by screening based on established eligibility criteria. In vitro studies examining the effect of chemical pretreatment on the microtensile bond strength of sound dentin to resin composite were included. Only English studies published from 2013 until February 10, 2026 were considered. Studies that used animal teeth, focused on carious, sclerotic, or desensitized dentin, or assessed mechanical or laser pretreatments were excluded. The protocol followed PRISMA guidelines and was registered with PROSPERO (CRD420261299181). Selected studies underwent a risk-of-bias analysis. A total of 17 studies met the inclusion criteria. Across the included studies, microtensile bond strength results revealed that certain chemical pretreatments can significantly enhance immediate bond strength as well as maintain long-term bond durability. Pretreatment with 50% Dimethyl Sulfoxide (DMSO), acetone wet-bonding, glutaraldehyde desensitizers, and copper-based (Cu-P) pretreatments significantly increased µTBS of the majority of dental adhesives and preserved their long-term stability. Selective dentin etching (SDE) for 3 seconds, along with glycolic acid and zirconium oxynitrate (ZON) etchants, yielded significantly higher immediate bond strengths than traditional 15-second phosphoric acid etching. In cases of blood contamination, grape seed extract and hesperidin collagen cross-linkers restored bond strength to nearly uncontaminated control levels. Conversely, silver-based solutions significantly reduced µTBS, and limonene had no significant effect on bond strength. Several chemical pretreatments, including selective dentin etching, solvent-based pretreatments, copper-based (Cu-P) pretreatments, glutaraldehyde desensitizers, and collagen cross-linkers, enhanced the bond strength of universal adhesives to sound dentin.
This in vitro study aimed to investigate whether calcium hypophosphite (CaP) mediates hydroxyapatite (HAP) formation in artificial and human saliva and, in a proof-of-principle toothbrushing model, promotes mineral deposition and occlusion of dentinal tubules. A CaP solution was added to artificial saliva and human saliva, respectively. The resulting precipitate was analyzed using X-ray powder diffraction (XRD). For the toothbrushing simulations, human dentin specimens were allocated to a test group treated with 2 wt% CaP solution and a control group treated with deionized water (n = 5 per group). The specimens were immersed in artificial saliva and subjected to five consecutive 30 s brushing treatments. Confocal laser scanning microscopy (LSM) was used to assess changes in dentinal tubule occlusion before and after treatment, scanning electron microscopy (SEM) was used to examine the morphology of the deposits, and energy-dispersive X-ray spectroscopy (EDX) was used to analyze their elemental composition. In artificial saliva and human saliva, CaP led to the formation of HAP. XRD analysis of the precipitates showed characteristic HAP peaks, with a mean crystallite size of (5.7 ± 0.6) nm and crystallographic parameters of a = (9.484 ± 0.003) Å, c = (6.868 ± 0.002) Å and V = (535.0 ± 0.4) Å3 for the formation in human saliva. LSM and SEM demonstrated mineral deposition within open dentinal tubules following toothbrushing simulations with CaP in artificial saliva, while EDX showed that the deposits contained calcium, phosphorus, and oxygen. CaP mediated HAP formation in artificial and human saliva. The proof-of-concept dentin experiment demonstrated mineral deposition within open dentinal tubules. Although firm conclusions regarding efficacy cannot be drawn, these promising findings merit further exploration in properly powered studies. With further confirmatory studies, CaP has potential as a desensitizing agent for oral care formulations.
Antimicrobial photodynamic therapy (aPDT) has been proposed as a locally acting adjunct to subgingival instrumentation for periodontitis. This umbrella review aimed to synthesize and critically appraise systematic reviews of adjunctive aPDT during active nonsurgical periodontal therapy, with emphasis on methodological confidence, clinical importance, and overlap of the evidence base. PubMed/MEDLINE, the Cochrane Library, Epistemonikos and Google Scholar were searched from inception through 24 July 2026, supplemented by backward and forward citation searching. For Google Scholar, the first 200 relevance-ranked results were screened, and exact-title and author searches were used to identify additional review reports. Systematic reviews with or without meta-analysis were eligible when they evaluated aPDT added to subgingival instrumentation and reported separable clinical evidence for adults receiving active nonsurgical treatment. Reporting followed PRISMA 2020 and PRIOR. Methodological confidence was appraised with AMSTAR 2; ROBIS domains were used as an interpretive framework rather than as a formal domain-by-domain rating tool. One reviewer completed selection, extraction and appraisal using a prespecified form and a structured second source-check pass for eligibility and numerical data. Fifteen systematic reviews published from 2010 to 2025 were included. After recalculation using the AMSTAR 2 decision rules, four reviews had high methodological confidence, three had moderate confidence, three had low confidence, and five had critically low confidence. The 2024 Cochrane review included 50 randomized trials and 1407 adults. During active treatment at 6 months, adjunctive aPDT produced an additional PPD reduction of 0.52 mm (95% CI 0.31–0.74; 15 studies, 452 participants) and CAL gain of 0.44 mm (95% CI 0.24–0.64; 13 studies, 414 participants); both were very low-certainty and judged unlikely to be clinically important. BOP improved by 5.72 percentage points (95% CI 1.62–9.81; 5 studies, 171 participants), also with very low certainty. No aPDT-related adverse effects were reported in 24 active-treatment studies involving 639 participants, while pocket closure, satisfaction, quality of life and economic outcomes were sparsely reported. Adjunctive aPDT may produce small short-term improvements in PPD and CAL after nonsurgical periodontal therapy, but the most reliable evidence remains very low certainty, and the observed mean differences have not been shown to translate into patient-important or treatment-changing benefit. Current evidence does not support routine adjunctive use; standardized trials should prioritize pocket closure, patient-reported outcomes, long-term effectiveness and economic outcomes. CRD420261468530
Oral health-related quality of life (OHRQoL) reflects the perceived impact of oral health on daily functioning, psychosocial well-being, and social interaction. While clinical symptoms strongly influence OHRQoL, it is unclear how well OHRQoL can be estimated using only non-clinical information, particularly in non-smoking populations. This study evaluated whether sociodemographic, behavioral, and self-perceived health variables can predict OHRQoL in non-smokers. This cross-sectional study recruited 130 adults. Participants completed a questionnaire capturing demographics, behavioral habits, and self-rated health. OHRQoL was measured using the OHIP-14. Bayesian regression was used to examine associations between these variables and OHIP-14 scores. Additional analyses were performed to identify the variables contributing most to predictions and examine predictions at the individual level. Predictions were compared with 14 machine learning (ML) models to evaluate whether algorithmic complexity could overcome model limitations. The Bayesian model explained 30% of variance in OHIP-14 scores (Bayesian R² = 0.30, 95% CrI: 0.20–0.39). Educational level, gender, and self-rated oral health were the strongest predictors. Simulated changes in self-rated oral health and dental attendance produced the largest reductions in predicted population-level OHIP-14 scores. The model performed reasonably well for individuals with mild-to-moderate impairment but systematically underestimated individuals with severe impairment (OHIP-14 > 30). ML methods did not substantially improve identification of severe cases. Non-clinical questionnaire information can provide moderate estimation of OHRQoL, particularly among individuals with mild-to-moderate impairment, but has limited ability to identify severe burden. These findings suggest that digital or questionnaire-based screening should incorporate a small number of symptom- or clinically relevant questions when the goal is to detect individuals with severe OHRQoL impairment. However, given the modest sample size, convenience sampling, and absence of cross-validation and external validation, the generalizability and robustness of these findings require confirmation in larger studies with independent external validation.
